Laserfiche WebLink
F <br />416 2nd StreA Galt CA 95632 LINE & LEAK DETECTOR <br />(209) 744-0112 FAX (209) 744-011 TEST REPORT <br />CONTRACTOR/ENGINEER <br />TEST DATE �— <br />SITE NAME eY" f r --Y'4 Vt PHONE ( ) <br />ADDRESS 7 <br />f'I. <br />' <br />Repair/Construction <br />Compliance <br />Insurance <br />Escrow ®to"•P <br />LOCATION SKETCH Show North <br />Make & Type of Pump or Dispenser <br />f tf7 4o <br />Cover Over Lines <br />Approx Burial Depth <br />/r <br />Weather <br />r-, f - �j <br />SHOW STREETS, BLDGS, TANKS, ISLANDS, PIPING (IF KNOWN), PUMPS OR DISPENSERS <br />Pressure Suction <br />LEAK DETECTORFTA <br />LEAK DETECTOR TESTINFORMATION Calibrate <br />10 PSI <br />Opening <br />I Element <br />LD <br />Serial <br />Time In <br />Test Leak <br />Holding <br />Pass / <br />KEY TYPES <br />No/Product <br />Key <br />Number <br />Resiliency <br />Seconds <br />Rate MUMin <br />PSI <br />Metering PSI <br />Fail <br />A <br />LD 2000 <br />B <br />LD 2000 E <br />C <br />FXI V <br />D <br />FXI DV <br />E <br />STPMLD <br />F <br />STPMLD - D <br />G <br />STPMLD - E <br />H <br />STPMLD - D/E <br />Notes: <br />CONTRACTOR <br />LINE TEST RESULTS <br />CERTIFICATION <br />Tests were made on the line systems as noted in accordance with test procedures <br />Technician: Lyle D. Nimmo <br />prescribed for as detailed on the test chart on Side 2 of this form with results as follows: <br />LINE IDENTIFICATION <br />NET VOLUME CHANGE PER HOUR <br />PETRO ITE CERT# <br />PASS FAIL / INCONCLUSIVE rte, <br />090993AO163 OTT <br />--A <br />Lic# 97-1143 <br />PASS / FAIL / INCONCLUSIVE <br />PASS / FAIL / INCONCLUSIVE <br />Trainee: <br />14 e- /-1 e <br />S / FAIL / INCONCLUSIVE �- <br />EQUIPMENT: PETRO TITE LINE TESTER <br />